Flexible hysteroscopy in irregular uterine bleeding

The objective of our study was to analyze the possibilities of diagnostic flexible hysteroscopy in women with irregular uterine bleeding.

The study involved 661 women aged 26-72 years (mean 46.23) with mild to moderate irregular uterine bleeding who agreed to have invasive investigations. Diagnostic hysteroscopy by panoramic fibrohysteroscope Pentax LH-150 II (5 mm in diameter) was performed initially to all patients, followed by classical dilatation and curettage (D & C).

Different types of normal endometrium were found in 248 (37.52%) women, hyperplasia and polyposis in 300 (45.39%), suspected changes for atypia and neoplasia in 82 (12.40%) and other different findings in 31 (4.69%). Subsequent D & C showed lack of adequate material from the uterine cavity in 26 (3.93%) women, in 538 (81.39%) the morphological findings were due to hormonal and dyshormonal reasons, 66 (9.98%) were with different precancer and cancer lesions and in 31 (4.69%) cases, clinically and morphologically, bleeding was due to the presence of submucosal myomas, intrauterine devices, residua and pathology of the chorion.

The comparison of the hysteroscopy results with clinical and histological findings from D & C showed good diagnostic possibilities of the flexible hysteroscopy for evaluation of women with irregular bleeding (sensitivity 74.07% and specificity 90.61%). This examination is relatively simple, safe and requires simultaneous performance of a direct biopsy, in order to improve the accuracy of the results.